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Psychology Postdoctoral Fellowship Program G.V. (Sonny) Montgomery VA Medical Center Jackson, Mississippi Updated: September 2016

Psychology Postdoctoral Fellowship Program · Web viewThe overarching goal of the Psychology Postdoctoral Fellowship Program at the GVSMVAMC is to provide advanced clinical training

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Psychology Postdoctoral Fellowship Program

Psychology Postdoctoral Fellowship ProgramG.V. (Sonny) MontgomeryVA Medical Center

Jackson, MississippiUpdated: September 2016

Psychology Postdoctoral Fellowship Program

G. V. (Sonny) Montgomery Veterans Affairs Medical CenterPsychology Postdoctoral Fellowship Program

Mental Health Service (11M)1500 East Woodrow Wilson DriveJackson, MS 39216-5116601.364.1350

Jackson VA hospital website

Postdoctoral Fellowship website

Application due: January 6, 2017

Accreditation Status

The Psychology Postdoctoral Fellowship Program at the G. V. (Sonny) Montgomery Veterans Affairs Medical Center (GVSMVAMC) is accredited by the Commission on Accreditation of the American Psychological Association (APA). Our next site visit is scheduled for 2019.

APPIC Membership

In 2011, our fellowship program was approved for membership in the Association of Psychology Postdoctoral and Internship Center (APPIC). Our APPIC member number is 9929.

ContentsEligibility Requirements3Application Procedures3Interview and Selection Process4Stipend and Benefits4Psychology Setting and Training Programs5Training Model and Program Philosophy6Postdoctoral Fellowship Program’s General Goals and Objectives7Emphasis Areas8Addictive Disorders Emphasis Area8Geriatric Mental Health Emphasis Area12HIV/Liver Disease Emphasis Area17Neuropsychology Emphasis Area21Psychosocial Rehabilitation Emphasis Area27Supervision30Didactic Training31Requirements for Completion31Facility and Training Resources32Administrative Policies and Procedures32Postdoctoral Training Faculty32G. V. (Sonny) Montgomery VAMC33University of Mississippi Medical Center38Mississippi Methodist Rehabilitation Center38Past and Present Trainees39Local Information39

Eligibility Requirements

Fellowship applicants must show a genuine interest in and aptitude for clinical psychology training and an expressed desire to learn how to provide state-of-the-art assessment and intervention to Veteran populations and their families who are experiencing difficulties with behavioral health, cognitive, and/or addictive disorders. Applicants are expected to have acquired a solid skill-set in assessment, intervention, and scholarly activity (e.g., peer-reviewed publications, educational or conference presentations) by the time they begin fellowship training. This can be documented through previous training experiences, letters of recommendation, statements of interest, and interviews.

The following are the eligibility crieteria to be considered for the fellowship:

· Completion of an APA-accredited doctoral program in clinical or counseling psychology.

· Completion of a psychology pre-doctoral internship in clinical psychology which is both accredited by the APA (or VA internship in the process of accreditation) and listed, in good standing, with APPIC.

· Citizenship in the United States of America. Verification of citizenship is required following selection. All fellows must complete a Certification of Citizenship in the United States prior to beginning VA training.

· Male applicants born after 12/31/1959 must have registered for the draft by age 26 to be eligible for any US government employment, including selection as a paid VA trainee. Male applicants must sign a pre-appointment Certification Statement for Selective Service Registration before they can be processed into a training program. Exceptions, which are very rarely granted, can only be approved by the US Office of Personnel Management.

· Completion of and passing fingerprinting and background checks.

· Willingness to accept a full-time, 1-year appointment. Fellows choosing the neuropsychology emphasis area have the option of pursuing a second year of training.

Note: the VA conducts drug screening exams on randomly selected personnel as well as on new employees. Fellows are not required to be tested prior to beginning work, but once on staff they are subject to random selection for testing as are other employees.

Application Procedures

Applicants should submit the following mateials via e-mail or regular mail to the address below by January 6, 2017:

· Cover letter expliciting indicating the emphasis area under consideration (i.e., Addictive Disorders, Geriatric Mental Health, HIV/Liver Disease, Neuropsychology, or Psychosocial Rehabilitation)

· Curriculum vitae

· Three (3) letters of recommendation with at least one (1) from an internship supervisor

· Official transcripts of graduate work

· Two (2) scholarly or clincial work samples (e.g., peer-reviewed journal articles, book chapters, de-identified assessment reports, published case reports)

E-mail Address: [email protected]

Mailing Address:Psychology Postdoctoral Fellowship Program

Attention: Andrew Voluse, Ph.D.

Director of Training, Postdoctoral Fellowship Program (116A4)

G.V. (Sonny) Montgomery VA Medical Center

1500 East Woodrow Wilson Drive

Jackson, MS 39216-5116

Interview and Selection Process

All completed applications will be reviewed by members of the training faculty. Based on this review, applicants who appear to be a good fit with our program will be invited for an in-person or telephone interview at the GVSMVAMC.

In-person interviews are highly encouraged in order for applicants and faculty to make more informed decisions about fit between applicants’ training goals and those offered by our programs. Full-day interviews will be conducted in early February. They will include a meeting and orientation with training leadership and interviews with different psychology staff members, including track coordinators and current fellows. Applicants with a disability who require accommodations for the application process or interview are encouraged to directly contact the training director ([email protected]) to discuss their needs. We will make every effort to create reasonable accommodations upon request.

In the event that an applicant is unable to arrange for an on-site interview, we will consider making accomodations to conduct the interview by telephone.

After interviews have been completed, members of the training faculty will meet to rank order applicants for each of the emphasis areas. For the Addictive Disorders, Geriatric Mental Health, HIV/Liver Disease, and Psychosocial Rehabilitation emphasis areas, offers are made by telephone to the highest ranked applicant. For the Neuropsychology emphasis area, we participate in the Association of Postdoctoral Programs in Clinical Neuropsychology (APPCN) Resident Matching Program (APPCN Match Website) and maintain full compliance with the procedures required by APPCN, including ranking and uniform notification dates. For all emphasis areas, once it has been confirmed that a particular applicant has accepted our offer, written and/or electronic notification is sent out to the new psychology postdoctoral fellow.

Stipend and Benefits

Stipends and benefits are competitive with similar training programs nationally and consistent with VA personnel policies. The salary for all first-year fellows is set at $42,239 per annum by VA Central Office. Fellows are expected to work full-time, accruing 2080 hours per year. Benefits include 13 paid vacation days, 13 paid sick leave days, 10 paid federal holidays, health insurance, and authorized absences (to attend professional conferences and other approved educational activities) may also be granted. Fellows have the opportunity to pursue a without compensation (WOC) appointment with UMMC to take advantage of their library, lecture series, and other educational resources.

Psychology Setting and Training Programs

The primary catchment area of the GVSMVAMC is home to more than 125,000 Veterans and their families. We serve approximately 45,000 unique Veterans who make more than 300,000 outpatient visits per year. The GVSMVAMC has 163 operating beds and provides primary, secondary, and tertiary medical, surgical, neurological, and psychiatric inpatient care. Among the inpatient services available to Veterans are radiation therapy, magnetic resonance imaging, hemodialysis, cardiac catheterization, sleep studies, hematology/oncology, and rehabilitation programs. Both primary and specialized outpatient services are also available, including ambulatory surgery, spinal cord injury, neurology, infectious disease. We have a 120-bed Community Living Center, several community contract nursing homes, four 150-bed state Veterans’ nursing homes, and a variety of outpatient programs aimed at serving the needs of aging and/or disabled Veterans and their families. Given that many of our Veterans reside in rural or geographically isolated areas, the GVSMVAMC also has seven Community Based Outpatient clinics (CBOCs) located across the state of Mississippi.

Psychology services at the GVSMVAMC are largely provided in the context of interdisciplinary programs that offer assessment and treatment in inpatient, residential, and outpatient settings. Psychologists at the GVSMVAMC are well respected and serve in important mental health and facility leadership positions (e.g., Team Leaders, Research & Development Committee, IRB Committee). Psychologists are team leaders for the Addictive Disorders Treatment Program, the Trauma Recovery Program, and the Evidenced-Based Psychotherapy Clinic. Psychologists also serve as coordinators of the Psychosocial Rehabilitation and Recovery Center. Psychology positions are also allocated to the Outpatient Mental Health Clinic, Community Living Center, and Primary Care Mental Health. Several psychologists serve in other leadership roles including the Evidence-Based Practice Coordinator and Local Recovery Coordinator.

The psychology faculty at the GVSMVAMC has a variety of interests and ongoing collaborations at local and national levels. Some of our current and recent projects are focused on cognitive behavioral interventions related to heavy drinking, improving continuity of care following primary substance use disorder treatment, tobacco cessation, resilience and recovery after trauma, factors associated with medically unexplained illness among troops deployed to the Middle East, the neuropsychology of PTSD, and medication adherence to Hepatitis C Treatment regimes in a substance use disorder population.

The GVSMVAMC serves a major role as a teaching hospital offering training programs in psychology, psychiatry, occupational therapy, social work, nursing, and numerous other medical specialties and disciplines. We are closely affiliated with the adjacent University of Mississippi Medical Center (UMMC), and for over 45 years we have been a full partner in the Psychology Predoctoral Internship Consortium with the Department of Psychiatry and Human Behavior at UMMC. This predoctoral internship has been APA-accredited since 1964 and provides 2,000 hours of clinical training with diverse Veteran populations in both inpatient, residential, and outpatient settings. Ratings by the interns have consistently been excellent and graduates typically receive competitive positions at postdoctoral fellowships, medical centers (including VAMCs), or academic institutions.

In 2007, the GVSMVAMC competed for and was awarded two postdoctoral fellowship positions, by the United States Department of Veterans Affairs Office of Academic Affiliations, including positions with emphasis areas in Addictive Disorders and Neuropsychology. In 2011, the GVSMVAMC competed for and was awarded a third postdoctoral fellowship position with an emphasis area in HIV/Liver Disease. Finally, in 2013 the GVSMVAMC competed for and was awarded two additional fellowship positions with emphasis areas in Geriatric Mental Health and Psychosocial Rehabilitation. During the course of training, our fellows have opportunities to collaborate with the UMMC-funded postdoctoral fellows, as well as predoctoral interns and other psychology trainees.

Training Model and Program Philosophy

The primary theoretical orientation of our faculty is cognitive-behavioral. However, we believe that any knowledge or principle which is scientifically derived and/or validated may be considered and incorporated into practice.

Fellowship training at the GVSMVAMC is rooted in the Scientist-Practitioner model. Additionally, the training model heavily emphasizes an empirically based, client-centered, and recovery-oriented approach. Fellows receive mentoring in the use of scientific methodology to guide their decision making and skills in the following areas:

· Using scientifically valid assessment methods, tools, and techniques

· Employing clinical interventions

· Utilizing and adapting evidence-based treatment modalities with different clinical populations

· Learning to inform Veterans of scientifically-based findings

· Building and maintaining effective teamwork with other healthcare professionals that supports the delivery of scientist-practitioner contributions

· Evaluating and disseminating clinically relevant, practice-based research

Our underlying philosophy is that clinical psychologists should be well-prepared to apply empirical sciences towards the following:

· Amelioration of maladaptive, dysfunctional, and abnormal behavior in individuals, families, groups, and communities

· Relief of human suffering

· Promotion of adaptive, fulfilling, and more meaningful living patterns in which people can thrive

Postdoctoral Fellowship Program’s General Goals and Objectives

The overarching goal of the Psychology Postdoctoral Fellowship Program at the GVSMVAMC is to provide advanced clinical training and educational opportunities to fellows to prepare them to serve as psychologists in settings where clinical service delivery and evidence-based practice, particularly within the context of interdisciplinary teams, are an integral part of their professional activities. A second goal is to provide opportunities for fellows to engage in scholarly activity. We expect our fellows to be able to critically evaluate research and to both employ and disseminate emprically based knowledge through clincial, educational, and/or scholarly activities. In order to meet these goals, the faculty is committed to the following four training objectives which are aimed at building upon and refining each fellow’s previously learned assessment, conceptualization, intervention and scholarly skills through active mentorship, training, and supervision.

Program Objective One: Preparing fellows for independent clinical practice within their chosen emphasis area. Fellows will refine interviewing, assessment, and intervention skills which are based on empirical principles, as well as acquire detailed knowledge of psychometric properties and normative data. They will learn how to critically evaluate and apply empirically-supported treatments within diverse clinical settings, including inpatient, residential, and outpatient programs. Fellows will also refine their assessment and report writing skills such that findings and recommendations are stated using language that is clear, concise, and accessible to the populations with whom they work. Finally, fellows will learn how to establish rapport with diverse Veteran populations and communicate in a way that encourages the Veteran to have a collaborative role in the treatment process.

Program Objective Two: Enhancing fellow educational and teaching abilities. Fellows will refine their presentation skills by developing well organized presentations relating to their area of expertise. The content of these presentations will be appropriate to the sophistication of the audience and employ a style that is engaging and encourages questions. Fellows will also be competent in the use of multimedia technology as a means of enhancing the quality of their presentations. Additionally, fellows may refine their education and teaching abilities through opportunities to receive training in the supervision of predoctoral interns and/or paraprofessional staff. They will employ supervison techniques that are sensitive to issues of cultural diversity and work to enhance the knowledge and skill set of the person being supervised.

Program Objective Three: Developing fellows’ scholarly abilities. Fellows will attain sufficient knowledge of their emphasis area such that they are able to critically evaluate research findings, summarize the current state of knowledge in an area, and discuss directions for future research. Fellows will also be able to apply their knowledge through the use of empirically-supported assessments and treatments within their given emphasis area. Fellows will strengthen their conceptualization and dissemination skills by participating in the development of clinical education projects, program improvement projects, presenting scholarly works at professional meetings, and/or becoming involved in research endeavors. Finally, fellows will have a solid awareness of human studies issues including the protection of human subjects, informed consent, and security of research data.

Program Objective Four: Providing opportunities for professional development. Fellows will refine their knowledge of the American Psychological Association (APA) Ethical Principles of Psychologists and Code of Conduct, as well as an awareness of how to recognize and address ethical and diversity issues that might occur in their training or work settings. Fellows should also demonstrate leadership ability as evidenced by taking initiative on tasks and identifying potential solutions to problems that arise in their training settings. Similarly, fellows should actively contribute to the development of programs in their training settings. Fourth, fellows should aim to improve their skills by actively seeking out and implementing feedback received from their supervisors. Finally, fellows should collaborate with other members of the interdisciplinary treatment team and demonstrate an awareness of and sensitivity to issues of cultural and individual diversity.

Emphasis AreasAddictive Disorders Emphasis AreaGoals and Objectives

The primary goal of the Addictive Disorders emphasis area is to assist fellows in developing an advanced understanding of substance use theory, the role of psychological and behavioral risk factors in the development of addictive disorders, and competence in empirically-based methods of assessment and intervention. We also prepare fellows to readily recognize and treat addictive disorders across a wide range of clinical settings (i.e., inpatient, residential, day treatment, and outpatient). These goals are accomplished through the following five training objectives:

Training Objective One: Assessment and Diagnosis

· Demonstrate knowledge of diagnostic criteria for Substance Use Disorders, that is equivalent to a level of independent practice, via the completion of evaluation reports with Veterans of varying ages and from diverse ethnic backgrounds.

· Refine differential diagnosis skills via the acquisition of the following:

· A repertoire of interviewing techniques that address ambivalence in relation to reporting symptoms associated with substance use and/or co-occurring disorders

· Knowledge of commonly used assessment instruments to assess anxiety, mood, psychotic, and/or personality disorders that might co-occur with a substance use disorder

· Acquire knowledge of withdrawal symptoms associated with various drugs of abuse and increase competence, equivalent to a level of independent practice, in determining when to refer Veterans for medical evaluation of withdrawal symptoms.

· Develop a level of competence in the following:

· The assessment of and scoring of semi-structured interviews for substance use and co-occurring disorders including but not limited to the Structured Clinical Interview for DSM-IV Diagnoses (SCID-IV) and the Anxiety Disorders Interview Schedule (ADIS)

· Conducting addictive disorder evaluations

· The administration, scoring, and interpretation of measures of personality, mood, anxiety, and cognitive functioning

· Identify means to objectively assess a Veteran's progress through various stages of treatment and to communicate that progress using language that is clear, concise, and accessible to both the Veteran and interdisciplinary treatment team

Training Objective Two: Intervention

· Improve therapy skills by facilitating evidence-based psychotherapy groups

· Refine intervention skills by conducting individual and group sessions using principles associated with Motivational Interviewing and Motivational Enhancement Therapy

· Refine individual therapy skills by serving as a therapist for Veterans with substance use and/or co-occurring disorders in a structured residential or day treatment program

· Improve intervention and communication skills by serving as a long-term therapist for Veterans with substance use and/or co-occurring disorders, including Veterans from diverse ethnic, cultural, and religious backgrounds

Training Objective Three: Team Membership and Communication

· Serve as a member of an interdisciplinary treatment team and contribute to team discussions about addictive disorders

· Concisely present assessment findings, in written form, via progress notes and, orally, during treatment team meetings

· Lead "clinical staffings" of Veterans who are demonstrating problematic behaviors that might negatively impact their ability to benefit from treatment

· Present evaluation and treatment plan reviews in a manner that is clear, concise, and accessible to both the Veteran and the interdisciplinary treatment team.

Training Objective Four: Scholarly Activity

· Actively participate in an ongoing ADTP clinical education or research project

· Actively participate in an ongoing Addictive Disorders education program (e.g., journal club)

· Complete all required research and privacy trainings

· Demonstrate an understanding of issues related to the protection of human subjects and maintainance the security of research data

· Present an education presentation related to an area of expertise for the ADTP staff

Training Objective Five: Professional Development and Ethical Behavior

· Demonstrate an understanding of the APA Ethics Code, especially in relation to Veteran confidentiality

· Contribute to the development and enhancement of an existing ADTP program (e.g., refine Veteran education materials or develop a therapy group)

· Participate in supervision training of a predoctoral intern or member of the ADTP staff in regard to a clinical activity (e.g., leading a therapy group)

· Attend 80% of the required didactic trainings (e.g., clinical case conferences, research rounds, grand rounds, diversity seminars, professional development didactic series)

Program Structure

The ADTP has the largest team in mental health and offers a broad spectrum of treatment services to Veterans with substance use or other addictive disorders. The multi-disciplinary staff provides an array of treatment services using individual, group, and TeleMental Health interventions. Specialty services are also offered for Veterans with co-occurring mood, anxiety, or psychotic disorders. The treatment team uses a biopsychosocial approach to treatment with a focus on evidence-based psychotherapies including cognitive-behavioral, mindfulness-based relapse prevention, and 12-step facilitation interventions. Continuing education in state-of-the-art treatments for addictive disorders is a hallmark of this program.

Fellows are exposed to the broad array of addictive disorders services via an initial orientation. Following the orientation, fellows will collaboratively develop a training plan with faculty. Fellows will have the opportunity to choose up to 3 primary clinical rotations for the year (see below), as well as secondary clinical activities (see below). Approximately 75% of the fellow’s time is devoted to the development, implementation, and provision of clinical services at the GVSMVAMC. In addition, the fellow’s time can be spent engaging in professional development activities including attendance at continuing education seminars and grand rounds presentations. Fellows can devote up to 20% of their training to additional educational, research, program development, or other scholarly activities.

Training Experiences

The Addictive Disorders emphasis area offers up to three primary and three secondary rotations, which can be completed over the training year, along with opportunities for training in scholarly activity, education, and professional development.

Primary Clinical Training Rotations

· Evaluation and Treatment. In this rotation, fellows have the opportunity to conduct empirically based evaluations and interventions for Veterans with substance use and co-occurring disorders in inpatient and outpatient settings. Training is provided on the administration of semi-structured and structured interviews (e.g., SCID-IV, ADIS-IV), as well as empirically validated self-report measures. Fellows receive training on evidence-based interventions, including manualized treatment approaches for the treatment of substance use, mood, and anxiety disorders. Fellows also have the opportunity to use broad-based treatment approaches including harm-reduction and contingency management.

· Residential and Day Treatment Programs. The ADTP program has a 15-bed residential program as well as a day treatment program that can accommodate additional Veterans. Admissions occur on a weekly basis, and the average length of stay is typically four weeks. A separate dual disorders track is offered for Veterans with co-occurring mental health disorders (e.g., mood, anxiety, psychosis). Clinical activities available to fellows include, but are not limited to, serving as an individual counselor, leading evidenced-based groups (e.g., relapse prevention, mindfulness-based relapse prevention, and process-oriented groups), and conducting brief cognitive and diagnositic assessments.

· Substance Use and Post Traumatic Stress Disorder Program (SUPT). The SUPT program provides assessment and treatment to Veterans with co-occurring substance use and post traumatic stress disorders. Individual and group based interventions are available for Veterans who have experienced combat or other traumas (e.g., child abuse). Fellows have the opportunity to learn empirically validated assessment and intervention techniques including exposure-based approaches such as Cognitive Processing Therapy and Prolonged Exposure. Opportunities for research and program development are also available.

Secondary Clinical Training Rotations

· Development of Group Therapy: An encouraged element of the Addictive Disorders emphasis area is to develop a group therapy protocol integrating a fellow’s existing or emerging area of interest or experience. Fellows will work with their supervisor to develop the content, create materials, implement the intervetion, and evaluate the group. Opportunities to train other staff to lead these groups are also available.

· Motivational Interviewing Training: The ADTP has multiple psychology faculty with significant experience in Motivational Interviewing (MI). Focused training in MI includes recording psychotherapy sessions, coding sessions according to the Motivational Interviewing Treatment Integrity Scale, and receiving individualized feedback about adherence to MI principles.

· Administrative Program Development: The ADTP provides continuing education to help meet the needs of our Veterans. Fellows electing to pursue this option will work with a supervisor to enhance or update existing program elements or develop new ones. Fellows will have the opportunity to assist in meeting national VAMC performance measures and preparing for accreditation from the Joint Commission and/or the Commission on Accreditation of Rehabilitation Facilities (CARF). Fellows will have also the opportunity to educate the ADTP staff about program development activities.

Scholarly Activity and Educational Training Opportunities

Fellows in the Addictive Disorders position are expected to participate in and are

provided with many opportunities for engaging in scholaly and educational activities including, but not limited to educational presentations to the ADTP staff, participating in training related to the supervision of predoctoral psychology interns, and conference presentations and/or research activity. The ADTP program has several existing data bases and is also involved in clinical educator and other funded projects. Current research opportunities include the following:

· Values-Based Motivational Interviewing to increase Hepatitis C medication adherence in a SUD population

· Psychometric evaluation of measures used in Substance Use Disorder (SUD) populations

· Interventions aimed at increasing engagement in SUD (e.g., contingency management)

· Interventions aimed at improving compliance with continuing care services

· Treatment of co-occurring mental health conditions in SUD populations

Geriatric Mental Health Emphasis AreaGoals and Objectives

The primary goal of the Geriatric Mental Health Emphasis Area is to prepare Fellows for advanced clinical practice in geriatric mental health consistent with the Pike’s Peak model (Knight et al., 2009) and Guidelines for Psychological Practice with Older Adults (APA, 2013). Fellows will develop clinical expertise and skills to critically evaluate and/or conduct research in the area of geriatric mental health. The numerous opportunities for professional development will also help prepare Fellows to function as licensed psychologists in medical center settings. An additional training goal will include preparation for eventual board certification in clincial geropsychology via the American Board of Professional Psychology (ABGERO). Specific emphasis area competencies and objectives include:

Training Objective One: Shared Decision Making

· Attend seminars and complete the NIH – funded online training modules on Evidenced Based Practice and Shared Decision Making.

· Demonstrate increased knowledge of the Evidence-Based Practice and Shared Decision-Making processes by change in knowledge scores on pre- and post-tests.

· Demonstrate increased skills in engaging in shared decision-making with Veterans who have impaired decision making capacity as evidenced by a review of clinical care activities, participation in interdisciplinary treatment team meetings, and supervision.

· Demonstrate competency in at least two Evidence-Based Psychotherapies appropriate for older adult populations as evidenced by review of observed or audiotaped therapy sessions. Appropriate therapies include but are not limited to: Behavioral Therapy, Cognitive-Behavioral Therapy, Interpersonal Psychotherapy, Problem-Solving Therapy, and Structured Reminisence Therapy (SAMHSA, 2011).

· Demonstrate improvement in Evidence-Based Practice skills as assessed by mid- and end-of rotation competency assessments. These practice skills include but are not limited to: Establishment of Therapeutic Rapport, Behavioral Activation, Life Review, Mindfulness, Motivational Interviewing, Reflective Listening, and Socratic Questioning.

· Demonstrate achievement of competency in screening and assessment of mood (depression and anxiety), cognitive function, delirium, decisional capacity, post-traumatic stress disorder, and suicide potential using appropriate clinical interviewing and instruments with known validity for older adults as evidenced by review of observed sessions.

Training Objective Two: Sustained Relationships

· Foster positive, collaborative, relationships with Veterans as evidenced by observation of clinical interactions and ability to keep Veteran and/or caregivers engaged in EBP treatment (e.g., attending regular sessions and completing homework).

· Demonstrate skill development in responding to consultation requests and providing updates regarding a Veteran’s progress as assessed by written progress notes and verbal communications with both the referring provider and treatment team members.

· Demonstrate an awareness of the importance of continuity of care as evidenced by participation in interdisciplinary treatment team meetings, provision of integrated care services, and documentation of ongoing care in the medical record and/or written interdisciplinary treatment plan.

Training Objective Three: Interprofessional Collaboration

· Attend seminars on the importance of interprofessional collaboration to Evidence-Based Practice and six interprofessional collaboration domains: interprofessional communication, patient-centered care, role clarification, team functioning, collaborative leadership, and interprofessional conflict resolution.

· Demonstrate an ability to place interests of Veterans at the center of interprofessional health care delivery and to work collaboratively with others to assess, plan, provide care, and make decisions to optimize Veteran’s health outcomes, with attention to aging needs, as evidenced by observed participation in interdisciplinary team meetings.

· Clearly communicate one’s roles and responsibilities to Veterans and other professionals, as evidenced by observed interactions with team members related to clarifying each member’s responsibility in executing components of a treatment plan.

· Demonstrate sensitivity to issues of cultural and discipline diversity in team meetings by presenting material using a style that minimizes discipline-specific terminology and is engaging to Veterans, their families, and other team members.

· Demonstrate competency in explaining EBPs in the context of a Veteran’s care to family members and/or providers who are not familiar with EBPs or gero-centric care.

Training Objective Four: Performance Improvement

· Track the progress of all Veterans seen for individual and group therapy using appropriate assessment methods.

· Participate in the development of performance improvement projects related to the dissemination and implementation of EBPs as appropriate. This may include methods to increase reach, effectiveness, adoption, implementation, or maintenance of outcomes for one or more of these interventions (e.g., STAR VA).

· Work with relevant team members to develop and assess strategies for improving outcomes of older adults receiving assessment and psychotherapy services

· Present quality improvement and/or other data to an interdisciplinary audience during program staff meetings.

Training Objective Five: Working with Older Adults and Rural Populations

· Attend seminars on neuropsychology, geropsychology, rural culture, and telemedicine.

· Complete telemedicine training, plan for, and provide an EBP through telemedicine to at least one Veteran or family member, if available during the fellowship year.

· Demonstrate an awareness of psychotherapy and assessment measures for older adults according to published guidelines for working with older adults and the Pikes Peak model.

· Demonstrate increased knowledge of and skills in working with older adults across a range of settings consistent with established practice guidelines and the Pikes Peak model of geropsychology-compentencies.

Program Structure

The Geriatric Mental Health emphasis area is structured so that fellows can develop competency in clinical geropsychology. During the initial two weeks of training, Fellows observe clinical programs within their chosen emphasis area and work with their supervisors to identify specific interests and areas for skill development. Fellows and their supervisors then develop a training plan such that they are able to participate in two primary and two minor rotation experiences across the training period. About 75% of their training time is spent in major rotations, 10% in minor rotations and the remaining 15% is for didactic and other educational activities. Evaluation of performance is ongoing with formal evaluations occurring two or more times across the training period using established rating forms. Clinical training and supervision experiences are of sufficient breadth and depth to meet national licensing requirements.

Training Experiences Community Living Center (CLC)

The 86-bed (13 palliative care) CLC is home to approximately 59 Veterans who primarily require long term supervised care in a medical environment. In 2004, the care model shifted from long-term to rehabilitative care. Although some CLC residents remain until end-of-life, new admissions are for rehabilitative or respite care ranging from two to four weeks. Residents requiring a longer stay have treatment goals addressing their co-occurring medical conditions, functional impairments, and psychosocial issues with a primary aim of avoiding institutional placement. Current, CLC Residents range in age from 38 to 99 and include a wide range of concerns including: chronic medical illness, persistent psychiatric disorders, neurodegenerative illness, lack of decisional capacity, end-of-life issues, and hospice/palliative care requirements.

The interdisciplinary CLC team has a primary goal of ensuring Residents and their families receive the highest level of care within an environment more reflective of a home than a traditional medical setting. Services provided include initial screeings, identification of benefits, psychosocial and psychological assessment, evidenced based psychotherapy, care giver support, and discharge planning. Psychology and Social Work staff also provide staff education, training, and didactic presentations, as well as developing and monitoring behavior management plans. In the CLC, Fellows are considered to be members of the interdisciplinary team and collaborate with Veterans, and their family members in the provision of appropriate care.

Home-Based Primary Care (HBPC)

The HBPC program provides services equivalent to any primary care setting within the context of the Veteran’s home. HBPC Veterans are predominately older adults, but also include a wide range of age, medical, and socioeconomic circumstances. HBPC providers see Veterans and/or their caregivers in their homes for medical and social needs, as well as psychological and neuropsychological assessment and/or psychotherapy in response to consult requests. Currently, there are over 300 Veterans enrolled in our HBPC program, with continued growth in the areas of comprehensive caregiver services for post-9/11 Veterans and caregivers of Veterans with dementia, telemonitoring and telemedicine, and rural health programs for Native American Veterans of the Mississippi Band of Choctaw Indians.

HBPC serves our VAMC’s entire catchment area, which is most of Mississippi and six parishes in Louisiana. Psychological issues frequently encountered include: anxiety, depression, maladaptive coping behaviors, agitation and/or behavioral disturbances, relational problems, difficulty adjusting to health conditions or disability, caregiver stress, concerns about dying and death, and bereavement. A range of health psychology topics are also important in HBPC care such as maintaining motivation and compliance with medical treatments, health literacy, and providing psychoeducational interventions for effective management of specific medical conditions (e.g., COPD, diabetes, weight management).

Fellows are also able to spend up to 10% of their training time participating in the following minor rotations:

Neuropsychology Clinic

Fellows interested in learning about advanced assessment techniques for older adults may continue geropsychology training outside of HBPC and the CLC through the Neuropsychology Clinic. Fellows will have the opportunity to provide neuropsychological assessment and feedback for older adults in relation to issues including functional capacity and ability to make independent decisions regarding advanced directives or other healthcare issues. Fellows will collaborate with primary care teams on integrting assessment recommendations (e.g., rehabilitation, behavioral, psychological) into treatment plans and have a primary role in educating Veterans, families, and other team members in these areas.

Resources for Enhancing All Caregiver’s Health-VA (REACH-VA)

The REACH-VA program is an evidenced based set of tools and interventions aimed at addressing the mental health and psychosocial issues experienced by caregivers of Veterans with dementia in rural settings. Services are delivered in-home and via telemedicine, and provides trainees with a unique opportunity for immersion in active rural health and novel approaches for providing integrated, patient-centered care.

Scholarly Activity and Educational Training Opportunities

For the Geriatric Mental Health emphasis area, fellows are expected to spend approximately 10% of their time engaged in scholarly activity. There are a number of ongoing Geriatric mental Health projects that fellows may participate in with their supervisors, and they are also encouraged to develop related projects under supervision. Fellows are required to demonstrate competence in scholarly activity by completing at least one of the following activities prior to the end of the training year: giving a Grand Rounds presentation, presenting scholarly work at a professional conference, providing in-service trainings to members of the mental health staff at the GVSMVAMC, leading a seminar for predoctoral interns, preparing a SC-MIRECC Clinical Educator or Pilot Study Grant, or contributing to an ongoing research study or manuscript preparation.

HIV/Liver Disease Emphasis AreaGoals and Objectives

The primary goal of the HIV/Liver Disease emphasis area is to assist fellows in developing an advanced understanding of medical and mental health needs of individuals with Hepatitis C virus (HCV), HIV, and co-occurring substance use disorders. Fellows will develop an understanding of HIV/HCV symptoms, their interaction with substance use and other co-occurring psychiatric disorders, and competence in empirically-based methods of assessment and intervention. The long term goal of this area is to enable the fellow to readily recognize and treat, across diverse clinical settings, substance use disorders in individuals with co-occurring HCV and/or HIV. These goals are accomplished through the following five training objectives:

Training Objective One: Assessment and Diagnosis

· Refine differential diagnostic skills in relation to identifying co-occurring psychiatric and substance use disorders in Veterans diagnosed with HIV/HCV

· Recognize medical conditions which might affect mental health symptoms and clinical presentations including HIV neurocognitive disorder and hepatic encephalopathy

· Recognize the contribution of mood disorders and substance abuse to non-adherence with antiviral therapy for HIV/HCV

· Provide longitudinal follow-up to Veterans with substance use and mental health disorders who are receiving antiviral therapy for HIV/HCV

· Acquire a detailed knowledge of withdrawal symptoms associated with various drugs of abuse and increase proficiency in determining when to refer patients for medical evaluation of withdrawal symptoms

· Become proficient in the administration, scoring, and interpretation of self-report measures of substance use, personality, mood, anxiety, and cognitive functioning

· Assess a Veteran's progress through various stages of treatment and communicate such progress using language that is clear, concise, and accessible to both the Veteran and the Interdisciplinary Treatment Team

· Demonstrates an awareness of and attentiveness to issues of cultural and individual diversity in relation to the interpretation of assessment findings (e.g., normative data).

Training Objective Two: Intervention

· Refine intervention skills by conducting group and/or individual sessions using principles associated with Motivational Interviewing and/or Motivational Enhancement Therapy

· Utilize empirically-supported interventions to reduce alcohol, substance use, and unsafe sexual behaviors in patients with HIV/HCV infection, as well as enhance compliance with provider recommendations and medical therapy

· Improve intervention skills by serving as a long-term therapist for Veterans from diverse cultural backgrounds with HIV/HCV, as well as co-occurring substance use and psychiatric disorders

· Demonstrates effective and culturally sensitive intervention and communication skills by serving as a therapist for Veterans from diverse ethnic, cultural, and religious backgrounds

Training Objective Three: Team Membership and Communication

· Serve as a member of the HCV and HIV Interdisciplinary Treatment Teams and contribute to team discussions

· Concisely present assessment findings in written form via progress notes and orally during treatment team meetings

· Lead "clinical staffings" of Veterans who are demonstrating problematic behaviors that hamper adherence to HIV/ HCV therapy and present these Veterans with written behavioral agreements where indicated

· Presents evaluation and treatment plan reviews in a manner that is clear, concise, and accessible to both the Veteran and the interdisciplinary treatment team

· Demonstrates an awareness of and sensitivity to issues of cultural and individual diversity and how they impact interpersonal communication within the interdisciplinary team

Training Objective Four: Research and Scholarly Activity

· Actively participate in ongoing research in the HCV, HIV, and/or ADTP

· Complete all required research and privacy trainings

· Demonstrate a solid understanding of issues related to the protection of human subjects and maintaining the security of research data

· Demonstrates as awareness of and sensitivity to the impact of cultural and individual diversity on the interpretation of research findings

Training Objective Five: Professional Development and Ethical Behavior

· Demonstrate an understanding of the APA Ethics Code, especially in relation to Veteran confidentiality

· Recognize privacy issues unique to both HIV/HCV and substance use disorders

· Present an education program related to an area of expertise for the HCV, HIV, or ADTP staff

· Contribute to the development and enhancement of an existing HCV, HIV, or ADTP program

· Demonstrates an awareness of and sensitivity to issues of cultural and individual diversity in relation to the development and enhancement of existing programs

· Attends 80% of the required didactic trainings (e.g., clinical case conferences, research rounds, grand rounds, diversity seminars, professional development didactic series).

Program Structure

The Hepatitis C and HIV clinics operate within a large and well equipped outpatient area. Mental health services are co-located within the ADTP clinic and space is available for co-location within the HIV and HCV clinics as well. Fellows will be co-located in the HIV and HCV clinics 1-3 days per week, where they will provide assessment, triage, treatment planning, and brief interventions to Veterans with HIV/HCV and co-occurring substance use and/or mental health disorders. The fellow will also provide long-term therapy for Veterans (approximately 75% of fellows time will be spent engaging in clinical activities). In addition, the fellow’s time is spent engaging in professional development activities including attendance at continuing education seminars, program development activities, and National HIV/HCV Fellowship seminars. Fellows can devote up to 20% of their training to education, research, or other scholarly activity such as working on a clinical educator grant.

Training Experiences

The HIV/Liver Disease emphasis area offers fellows the opportunity to spend a substantial amount of their entire training year working in the HIV and HCV clinics. Fellows will spend approxamately half of their time each week in the HIV and HCV clinics, with the rest of their clinical time allocated to sub-rotations in the Addictive Disorders Treatment Program (see the Addictive Disorders emphasis area section for available rotation opportunities). Opportunities for training in scholarly activity, education, and professional development are also available both within and across emphasis areas.

Clinical Training Rotations

· HCV clinic: The HCV clinic meets one and a half days weekly. This clinic counsels Veterans newly diagnosed with HCV on the natural history and treatment options for this chronic viral infection as well as Veterans who are having difficulty adhering to their medication regimens. Clinic space is available to allow co-location for a psychology fellow. Learning opportunities include assessing a Veteran’s readiness for HCV therapy, diagnosing substance use and mental health disorders which could impact adherence and health, and supporting a Veteran who is receiving antiviral therapy for HCV.

· HIV clinic: The HIV clinic meets one half day weekly. This interdisciplinary clinic provides training opportunities to infectious disease fellows as well as internal medicine and pharmacy students. Clinic space is available to allow co-location for a psychology fellow. This clinic will enable the fellow to appreciate the stages of adjustment seen in a newly diagnosed Veteran with HIV, understand the long-term effects of HIV on physical and mental health, witness side effects of HIV medications, and increase awareness of potential drug-drug interactions with HIV medications. In addition, fellows will provide mental health support to Veterans in the clinic including assessment, triage, treatment planning, and brief interventions.

Scholarly Activity and Educational Training Opportunities

For the HIV/Liver Disease emphasis area, fellows are provided with the opportunity to spend up to 20% of their time engaged in scholarly activity. Several postdoctoral training faculty serve as clinical investigators and are engaged in numerous reseach projects including the following:

· Correlation of HCV and neurocognitive disorders

· Increasing HCV medication adherence in a substance use disorder population via Values-Based Motivational Interviewing

· Epidemiology of HCV and adherence to treatment of chronic HCV infection among patients with active substance use disorder

· Motivation to change drinking behaviors

· Examination of the role of stigma in clinical decision-making across multiple healthcare disciplines

· Real-time measurement of co-occurring smoking and drinking

Neuropsychology Emphasis AreaGoals and Objectives

The primary goal of the Neuropsychology emphasis area is to prepare fellows for advanced clinical practice in clinical neuropsychology (consistent with APA-Division 40/INS guidelines) with the aim of eventual board certification (ABCN/ABPP). These goals are accomplished through the following five training objectives:

Training Objective One: Assessment and Diagnosis

· Acquire an adequate fund of knowledge, equivalent to the level of independent practice, regarding psychological and neuropsychological test instruments commonly employed with adults across the life span, including older individuals, who are experiencing neurocognitive and/or psychological disorders

· Learn how to adapt standard assessment procedures to adequately assess Veterans who have sensory, motor, and/or linguistic deficits (e.g. aphasia)

· Develop a repertoire of interpersonal skills needed to maximize Veterans’ performance

· Develop assessment skills which allow for flexibility in adding or deleting measures based on test findings and ongoing hypothesis generation during assessment

· Evaluate data in relationship to other findings, including behavioral observations, collateral reports, neuroimaging results, previous records, and demographic information

· Utilize assessment techniques which take into consideration Veteran diversity (e.g. age, ethnicity, religious beliefs, geographic location, education, etc)

· Develop recommendations for each Veteran to maximize functioning including suggestions for school performance, work performance, or independence at home

· Use the Veteran’s pattern of strengths and weaknesses to provide the referral source with diagnostic information, as well as practical recommendations for care

Training Objective Two: Intervention

· Provide Veterans with information derived from their assessments in a clear and concise manner, acknowledging their deficits, but emphasizing compensatory strategies so that they can profit from their strengths

· Refine intervention skills by conducting individual sessions aimed at helping Veterans cope with impaired cognition, neurological disease states, and other factors associated with their diagnoses

· Refine therapy skills by working with Veterans and their spouses/families, together, in order to maximize the family’s understanding of the Veteran’s diagnosis, as well as assist them in managing and coping with the Veteran’s impairments through training in the REACH-VA (an evidence based intervention for caregivers)

· Integrate research on diversity into clinical practice.

Training Objective Three: Team Membership and Communication

· Serve as a member of an interdisciplinary treatment team and contribute to team discussions

· Concisely present assessment findings, in written form, via progress notes and, orally, during treatment team meetings

Training Objective Four: Scholarly Activity

· Actively participate in an ongoing neuropsychology education program (e.g., journal and book club)

· Present scholarly work via a didactic presentation (e.g., grand rounds) or at a professional conference

· Present an education program related to an area of expertise for the mental health staff

· Participate in the yearly Neuroanatomy course offered at UMMC

· Complete all required research and privacy trainings

· Demonstrate a solid understanding of issues related to the protection of human subjects, informed consent, and maintaining the security of research data

Training Objective Five: Professional Development and Ethical Behavior

· Demonstrate an understanding of the APA Ethics Code, especially in relation to Veteran privacy and confidentiality

· Participate in supervision training for a psychology graduate student or predoctoral intern who elects to take a rotation in neuropsychology

· Contribute to the development and enhancement of the Neuropsychology Clinic

· Attends 80% of the required didactic trainings (e.g., clinical case conferences, research rounds, grand rounds, diversity seminars, professional development didactic series)

Program Structure

The Neuropsychology emphasis area is structured so that fellows can develop competency in clinical neuropsychology. Fellows spend their time primarily with Dr. Bennett in the Neuropsychology Clinic (approximately 75% of their time). Also, fellows may elect to participate in minor rotations offered at UMMC and Methodist Rehabilitation Center, which generally entail five hours of time per week. In addition, approximately 5% of the fellow’s time is spent engaging in professional development activities including continuing education seminars and Grand Rounds presentations. Fellows can devote up to 20% of their training to scholarly activity and/or professional education (e.g., taking the Neuroanatomy course at UMMC).

Training Experiences Neuropsychology Clinic

During the time spent in the Neuropsychology Clinic, fellows will provide psychological and neuropsychological assessment and feedback for both inpatients and outpatients. Staffings will be attended by the supervisor and fellow as necessary to report on the status of the Veteran and provide recommendations for care. Fellows will collaborate with primary care teams on treatment plans (e.g., rehabilitation, behavioral, psychological) and take responsibility for educating Veterans, families, and other team members.

· Outpatient Neuropsychology : Outpatient neuropsychological services include comprehensive neuropsychological evaluation and consultation as part of the Mental Health Consult Team. Most Veterans are referred to answer questions raised by primary care providers, but referrals may also come from neurology, psychiatry, and the Post-Deployment Health Clinic. Postdoctoral fellows also facilitate appropriate scheduling for the follow-up of Veterans that they assess.

· Comprehensive Evaluation: Fellows will learn to conduct a thorough chart review of the Veteran’s history, engage in a comprehensive interview, including neurological and psychiatric features, administer a wide variety of test instruments, score the testing, write a formal report, and provide feedback to the Veteran and/or his or her family. Supervisors will familiarize fellows with the most commonly used tests. Initially, fellows will observe their supervisor conducting these evaluations. Over time they will become progressively more independent from their supervisor in conducting interviews, administering tests, giving family feedback, and providing behavioral management strategies.

· Family Education/Feedback: Educating family members is a primary responsibilities of the Neuropsychology Clinic. An explanation about what a neuropsychologist does and their role on the treatment team is always in order. Fellows may obtain relevant history from family members or other collateral sources, as Veterans are sometime unable to provide this information on their own. Other activities involving family members include providing feedback about course of recovery from brain injury or possible progressions of neurological illness, anticipated behavioral and cognitive impairments, results of testing and treatment recommendations, and counseling as indicated. There may also be an opportunity to provide support groups for family members.

· Inpatient Neuropsychology: Fellows will provide evaluation and/or treatment for up to four Veterans per week from the medical and psychiatric inpatient wards of the hospital. Given the nature of inpatient services, a timely response (i.e., within 48-hours) to referral questions is necessary. Feedback may be provided to Veterans and families, depending on the medical, psychological, and behavioral issues involved. The content of an evaluation will depend on the referral questions, Veteran's impairments, and style of the supervisor. Common referral questions include differential diagnosis, capacity (e.g., medical decision making, independent living), and tracking cognitive progression (particulary in cases of delirium).

· Bedside Evaluation: Fellows will learn to perform a bedside evaluation using many brief tests that will assist in quantifying a Veteran’s level of responsiveness, behavior, and cognition. Measures such as the Galveston Orientation & Amnesia Test, Agitated Behavior Scale, Mini Mental State Exam (MMSE), and Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) are commonly used measures. Additionally, supervisors will familiarize fellows with other methods of Veteran examination to index neurologic impairment and subsequent improvement (e.g., sensory-perceptual examination). Initially, fellows will be following supervisors on the unit for these evaluations. Over time they are expected to become more independent in conducting these evaluations.

· Formal Evaluation: When an inpatient is ready for formal neuropsychological evaluation, fellows may be involved in obtaining additional background information, administering tests, scoring tests, and writing a report. Initially, they will review what tests to select with their supervisor. A formal report is due within two working days of completion of testing. Initially, fellows will type reports and later dictate them.

Minor RotationsCommunity Living Center (CLC)

The 86-bed (13 palliative care) CLC is home to approximately 59 Veterans who primarily require long term supervised care in a medical environment. In 2004, the care model shifted from long-term to rehabilitative care. Although some CLC Veterans remain until end-of-life, new admissions are for rehabilitative or respite care ranging from two to four weeks. Veterans requiring a longer stay have treatment goals addressing their co-occurring medical conditions, functional impairments, and psychosocial issues with a primary aim of avoiding institutional placement. Current, CLC Veterans range in age from 38 to 99 and include a wide range of concerns including: chronic medical illness, persistent psychiatric disorders, neurodegenerative illness, lack of decisional capacity, end-of-life issues, and hospice/palliative care requirements. The interdisciplinary CLC team has a primary goal of ensuring Veterans and their families receive the highest level of care within an environment more reflective of a home than a traditional medical setting.

· Fellows asssist in initial screeings, psychosocial and neuropsychological assessment, evidenced based psychotherapy, care giver support, and discharge planning. Fellows are encouraged to participate in weekly treatment team meetings. Fellows may also assist in educating staff, developing and monitoring behavior management plans, and providing consult services to other members on the treatment team.

Home-Based Primary Care (HBPC)

The HBPC program provides services equivalent to any primary care setting witin the context of the Veteran’s home. HBPC Veterans are predominately older adults, but also include a wide range of age, medical, and socioeconomic circumstances. HBPC providers see Veterans and/or their caregivers in their homes for medical and social needs, as well as psychological and neuropsychological assessment and/or psychotherapy in response to consult requests. Currently, there are 317 Veterans enrolled in our HBPC program, with continued growth in the areas of comprehensive caregiver services for post-9/11 Veterans and caregivers of Veterans with dementia, telemonitoring and telemedicine, and rural health programs for Native American Veterans of the Mississippi Band of Choctaw Indians. HBPC serves our VAMC’s entire catchment area, which is most of Mississippi and six parishes in Louisiana. Psychological issues frequently encountered include: anxiety, depression, maladaptive coping behaviors, agitation and/or behavioral disturbances, relational problems, difficulty adjusting to health conditions or disability, caregiver stress, concerns about dying and death, and bereavement. A range of health psychology topics are also important in HBPC care such as maintaining motivation and compliance with medical treatments, health literacy, and providing psychoeducational interventions for effective management of specific medical conditions (e.g., COPD, diabetes, weight management).

· On this rotation, fellows are able to provide neuropsychological assessments within the Veteran’s homes. Environmental factors and how these may be impacting mental health and functional abilities are taken into considerations. Other opportunities include: being trained in the Reach-VA (an evidenced based intervention for caregivers) and proviing brief psychotherapy.

University of Mississippi Medical Center (UMMC)

UMMC is the state’s only academic health science center and inclues six health science schools: medicine, nursing, dentistry, health related professions, graduate studies, and pharmacy. It also provides wide-ranging patient care programs. Four specialized hospitals on the Jackson campus include the only children’s hospital in Mississippi, a women and infants’ hosptial, and a critical care hospital. UMMC offers the only Level 1 trauma center, the only Level 4 neonatal intensive care nursey, and the only organ transplant program in the state.

· This rotation is flexible and based on the fellow’s interest, gap in training, and future goals. Previous fellows have completed rotations on the eplipsey unit, including testing individuals who are admitted for video EEG monitoring, evaluating clients with potential psychogenetic seizures, participating in treatment team conferences, and assisting in Wada administrations. Fellows have also participated in neuropathology rounds, which determine pathology post-mortem. Opportunities also include evaluating children and adolescents with acquired brain injuries, completing capacity evaluations, and joining the stroke treatment team. Other possibilities may arise depending on the fellow’s interest and current availabilities with supervisors.

Methodist Rehabilitation Center (MRC)

As Mississippi’s only comprehensive rehabiltiation hosptial, MRC features programs specifically designed to treat people who have had a stroke, brain, or spinal injury. Patients are admitted to the hospital to receive extensive rehabilitation, including occupational, physical, and speech and language therapy. MRC’s Quest program also provides these services on an outpatient level.

· Fellows participate on an interdisciplinary treatment team to provide inpatient neuropsychological assessments. Common conditions include acute stroke syndromes (including aphasias), moderate to severe traumatic brain injuries, frontal dysfunction syndromes, and tumors. Fellows are also provided the opportunity to provide follow up evaluations on an outpatient basis to track cognitive, psychological, and functional changes post-injury. Referral questions may include identifying cognitive strengths and weaknesses; ability to return to work, driving, or other activities of daily living; and tracking improvement.

· Opportunities to provide brief psychological interventions are also available on the inpatient unit, as well as part of the Quest program. Past fellows have also assisted in leading group therapy sessions for individuals recovering from brain injuries.

Other Opportunities: Other opportunities may arise depending on supervisor ability and interest displayed by the fellow. For instance, previous fellows have completed a minor administration rotation, shadowing the Chief of Mental Health to gain a better perspective of the VA executive demands. Opportunties to participate in the IRB councel, training committee, or other administrative committees may become available. In the past, fellows have also assisted in teaching first year medical students and residents about neuropsychology and cognitive neuroanatomy.

Scholarly Activity and Educational Training Opportunities

For the Neuropsychology emphasis area, fellows are expected to spend approximately 10% of their time engaged in scholarly activity (consistent with APPCN guidelines). There are a number of ongoing Neuropsychology research projects that fellows may participate in with their supervisors, and they are also encouraged to develop related projects under supervision. Fellows are required to demonstrate competence in scholarly activity by completing at least one of the following activities prior to the end of the training year: giving a Grand Rounds presentation, presenting scholarly work at a professional conference, providing in-service trainings to members of the mental health staff at the GVSMVAMC, leading a seminar for predoctoral interns, preparing a SC-MIRECC Clinical Educator or Pilot Study Grant, or contributing to an ongoing research study or manuscript preparation.

Psychosocial Rehabilitation Emphasis AreaGoals and Objectives

The primary goal of training in the Psychosocial Rehabilitation emphasis area is to provide training to fellows so that they develop specialized skills relating to an advanced understanding of mental health recovery, serious mental illness, and competence in empirically-based methods of assessment and intervention. A second goal is to enable the fellows to readily recognize and provide efficient and effective services to those living with a serious mental illness across a range of clinical and community settings. These goals are accomplished through the following four training objectives:

Training Objective One: Enhancement of Clinical Skills

· Engage Veterans in a collaborative discussion and preparation of Mental Health Advanced Directives as evidenced by a review of the clinical interactions.

· Co-lead recovery education activities with Veterans and peer support staff.

· Utilize a collaborative approach with Veterans in developing individualized, self-directed recovery plans as evidenced by clinical observation and review of written documentation.

· Demonstrate evidenced based provision of family recovery education and support services as evidenced by clinical observation and review of written documentation.

Training Objective Two: Sustained Relationships

· Foster positive, collaborative, relationships with Veterans as evidenced by observation of clinical interactions and ability to keep Veteran and/or caregivers engaged in treatment (i.e., attending regular sessions and completing homework).

· Demonstrate an awareness of the importance of continuity of care as evidenced by integration and participation in interdisciplinary treatment team meetings and documentation of ongoing care in the written interdisciplinary treatment plan.

· Foster productive, collaborative relationships with Veterans and family members through long-term engagement in services as evidenced by review of treatment session and written documentation.

· Collaborate with community service providers and agencies through ongoing referral processes and active participation in community-based meetings.

· Demonstrate receptivity to interdisciplinary supervision and collaboration as evidenced by observations during supervision and treatment team meetings.

Training Objective Three: Interprofessional Collaboration

· Attend and actively participate in interdisciplinary didactic trainings.

· Demonstrate competency in explaining and utilizing the Recovery Model of care b working with at least two Veteran’s, family members and/or providers who are not familiar with this approach.

· Collaborate with leadership and providers through active participation in mental health administrative activities at the program and service level.

· Participate on interdisciplinary teams with shared experiential opportunities such as community outreach, co-leading groups, and administrative duties.

· Take a primary role in facilitating at least one meeting of the Mental Health Veterans Advisory Council.

Training Objective Four: Professional Development

· Actively participate in at least one performance improvement project related to improving psychosocial rehabilitation services (e.g., SMI re-engagement project).

· Facilitate the implementation or maintenance of clinical or administrative activities that promote compliance with accrediting agencies (e.g., CARF, Joint Commission).

· Assist with accurate and timely of performance data required for submission to online databases (e.g., NEPEC, SMI Registry)

· Present quality improvement data related to psychosocial rehabilitation performance measures to an interdisciplinary audience during a program staff meeting.

Program Structure

The Psychosocial Rehabilitation emphasis area offers a broad spectrum of services primarily to Veterans with serious mental illnesses through psychosocial rehabilitation practices. The Fellow participates in a series of clinical and rehabilitation rotations to maximize both breadth and depth of training in assessment, treatment and rehabilitation with persons living with serious mental illnesses. Training emphasis is given to evidence-based practices for persons with severe mental illness, with primary training rotations offering competency development in psychosocial skills training, wellness and community reintegration. Supplemental training experiences include literature review and evidence-based practice programs including community-based intensive treatment, housing assistance and residential stabilization with long-term care planning, supported employment, and family psychoeducational programs.

Our psychosocial rehabilitation programs assist Veterans as they progress toward their individual recovery goals through enhanced empowerment, community integration, work and meaningful activity, and familial and social supports. The fellowship rotations offer a well-rounded experience across the domains of treatment and recovery. The primary preceptors for this fellowship program are also the Facility Recovery Co-Coordinator. The PSR emphasis area includes working with the preceptor on local and national recovery initiatives and incorporation of enhanced professional role development, teaching, and supervisory activities. This emphasis area includes a year-long scholarly program development/improvement activity or research in which the fellow is expected to develop a project with an identified work product. Fellows will have the opportunity to participate in 3 primary clinical rotations for the year and has the option to select from secondary clinical activities as described below. Approximately 75% of the fellow’s time is devoted to the development, implementation, and provision of clinical services at the GVSMVAMC. Approximately 5% of the fellow’s time is spent engaging in professional development activities including attendance at continuing education seminars and Grand Rounds presentations. Also, fellows will be expected to devote up to 20% of their training year to scholarly activities such as working on program improvement activities.

Training Experiences

The Psychosocial Rehabilitation emphasis area offers up to three primary and three secondary rotations, which can be completed over the training year, along with opportunities for training in scholarly activity, education, and professional development.

Primary Clinical Training Rotations

· Psychosocial Rehabilitation and Recovery Center (PRRC). The PRRC known as the TARGET (Team Assisted Recovery Goal Enriched Therapy) Center is an outpatient transitional learning program that provides a person centered and empowering environment to support the recovery of Veterans living with serious mental illness (SMI). It is located in space off the main GVSMVAMC campus to facilitate greater independence and community reintegration. The program aims to support Veterans’ progress in their recovery so that they develop skills and resources that enhance their success in the community. Fellows will gain knowledge of specific interventions such as Social Skills Training, Illness Management and Recovery, Recovery Coaching and Wellness Management. They will also learn the value and role of peer support staff as integral members of the interdisciplinary team. As members of the interdisciplinary team, fellows work alongside PRRC coordinator, social workers, and certified Peer Specialist providers.

· Mental Health Intensive Case Management (MHICM). The MHICM Program offers mental health and intensive case management services to an outpatient population of Veterans with serious mental illness (SMI), their families, and significant others. The goal of MHICM is to improve community adjustment and the Veterans’ quality of life by providing patient-centered care. The interdisciplinary team provides 80% of patient contacts take place in the field allowing for flexible community-based interventions. Services are provided based upon symptom acuity, the Veteran’s needs, and availability of resources. Fellows and interns will function as members of the interdisciplinary team and collaborate with other team and identified support systems in the provision of community-based care.

· Mental Health Recovery Coordination. The goal of mental health recovery coordination is to facilitate implementation of recovery oriented services in Mental Health programs which includes providing education to providers, Veterans and their families on mental health recovery and evaluation of recovery efforts. Coordination efforts entail serving as a champion and advocate for the Recovery Model and provision of recovery-oriented education and services throughout the medical center and community-at-large. Services provided are interdisciplinary and include consultation and collaboration with staff and Veterans across all mental health programs. Fellows and interns will have the opportunity to coordinate vocational rehabilitation and peer support services embedded in mental health programs, promote recovery-oriented services and activities throughout the medical center, and engage in education and collaboration with national, state and local agencies regarding implementation of recovery-oriented services.

Secondary Clinical Training Rotations

· Inpatient Mental Health. The fellow gains intensive treatment and evaluation experience with Veterans in an acute phase of illness on a 21-bed locked inpatient psychiatric unit. The primary training focus of this rotation is to provide the fellow with both experience and comfort with the acute phases of psychopathology of severe mental illnesses. This rotation includes diagnostic evaluation of psychopathology and psychosocial issues, interdisciplinary care planning and individual and group psychotherapeutic interventions.

· Supported Employment. The supported employment program provides evidence-based employment services for persons with severe mental illness. Vocational employment specialists work closely with numerous clinical programs for persons with severe mental illness. Fellows on this rotation will have opportunities to engage in vocational assessment, job development and employment support activities.

Supervision

Consistent with our emphasis on training, fellows in each of our emphasis areas will receive a minimum of four hours of supervision each week. The majority of the supervision will be individual in format and will involve numerous modalities including, but not limited to modeling, direct observation, review of progress notes/assessment reports, review of audio recordings, and discussion of assigned readings. Fellowship supervisors have an “open door” policy which results in a combination of unscheduled supervision meetings as well as fixed weekly supervision times to discuss ongoing training activities.

Didactic Training

Up to 10% of the fellowship can be devoted to didactic training activities both within the GVSMVAMC and/or off station at area hospitals. Examples of activities that fellows are required to attend include the following:

· The UMMC Department of Psychiatry and Human Behavior Grand Rounds

· The GVSMVAMC psychology postdoctoral fellowship professional development didactic series

· The UMMC/VA Psychology Internship Consortium’s research colloquia and clinical case presentations

· The VA diversity didactic seminars via teleconference

Fellows in the Neuropsychology emphasis area are also encouraged to attend the following:

· The neuropsychology seminar sponsored by the Mississippi Methodist Rehabilitation Center

· The UMMC Departments of Neurology/Neurosurgery Grand Rounds

· The UMMC neuroanatomy course

· UMMC Neuroscience Research day

Fellows in the HIV/Liver Disease emphasis area are also encouraged to attend the following:

· The National HIV/HCV Fellowship training seminars via teleconference

· The National HIV/HCV Fellowship training evaluation meetings via teleconference

Fellows in the Geriatric emphasis are also encouraged to attend the following:

· The UMMC Geriatric Core Curriculum

· Journal club (addresses topics consistent with the Pike’s Peak model for postdoctoral training) focused on issues related to assessment, psychothearpy, interprofessional teams, end of life, etc.

Requirements for Completion

Requirements for maintenance of good standing and subsequent successful completion of the GVSMVAMC Psychology Postdoctoral Fellowship Program include the following:

· Completion of 2,000 hours of supervised clinical training within a 1-year period of time. Of note, fellows choosing an emphasis area in Neuropsychology have the option of pursuing a second year (2,000 hours) of training

· Attendance of at least 80% of the required didactic and professional development training actvities

· Overall ratings of Miminally Successful, Fully Successful, or Exceptional on formal evaluations that are conducted at months 4 and 8 of the training year and a final rating of Fully Successful or Exceptional at the end of the training year

· Compliance with standards of professional and ethical behavior as described in the GVSMVAMC Postdoctoral Fellowship Program Policy and Procedure Manual and the Ethical Principles of Psychologists and Code of Conduct of the American Psychological Association.

Facility and Training Resources

Our fellowship program is located within a large, well equipped VA Meical Center. Each fellow is assigned an office which includes furniture, a telephone with voicemail, and a Pentium based computer that has up-to-date software packages including: Microsoft Office, the Computerized Patient Record System (CPRS), Veterans Health Information Systems and Technology Architecture (VistA), and Statistical Package for the Social Sciences (SPSS) for statistical analysis. Fellows have access to excellent library resources both at the GVSMVAMC and UMMC including the capacity for online literature and database searches. Statistical and methodological consultation can be arranged with experts from the SC-MIRECC.

Administrative Policies and Procedures

Oversight and coordination of the psychology postdoctoral fellowship program is conducted by the Psychology Postdoctoral Fellowship Training Committee (FTC) which is comprised of the Director of Postdoctoral Training, Chief of Psychology, the Coordinators from the five emphasis areas, and one additional faculty member from the GVSMVAMC. The FTC is responsible for developing and overseeing policies and procedures for the fellowship. Selected policy and procedure information is listed below. Further information on our administrative policies and procedures can be found in the GVSMVAMC Postdoctoral Fellowship Program Policy and Procedures Manual which is distributed to fellows at the start of their fellowship.

· Leave Policy: Our progam complies with the authorized leave policy that has been adopted by the United States Department of Veterans Affairs Office of Academic Affiliations.

· Privacy Policy: Our privacy policy is clear. We will collect no personal information about fellows when you visit our website.

· Due Process Statement: Upon entry to our program, fellows are provided with a copy of our policy and procedures manual which includes information on grievance processes, disciplinary actions, and addresses issues pertaining to impaired fellows.

· Self-Disclosure: Our program does not require self-disclosure of personal information beyond what is required for applying to our fellowship.

Postdoctoral Training FacultyAddictive Disorders Emphasis Area

· Amee Patel, Ph.D.

· Andrew Voluse, Ph.D. (Track Coordinator)

Geriatric Mental Health Emphasis Area

· John Askew, Ph.D. (Track Coordinator)

· B. Heath Gordon, Ph.D.

· Amee Patel, Ph.D.

HIV/Liver Disease Emphasis Area

· Billy Ray Brown, Pharm D.

· Mary Jane Burton, M.D.

· Ena Scott, Ph.D.

· Andrew Voluse, Ph.D. (Track Coordinator)

Neuropsychology Emphasis Area

· Ted Bennett, Ph.D. (Track Coordinator)

· Clea Evans, Ph.D.

· B. Heath Gordon, Ph.D.

· Ed Manning, Ph.D., ABPP

· Amee Patel, Ph.D.

Psychosocial Rehabilitation Emphasis Area

· Shawn Clark, Ph.D. (Track Coordinator)

· Ena Scott, Ph.D.

Other Available Faculty

· Randy Burke, Ph.D.

· Jeanne Gabriele, Ph.D.

G. V. (Sonny) Montgomery VAMCJohn H. Askew, Ph.D.:

Dr. Askew became a staff psychologist for the GVSMVAMC in 2012. He completed a predoctoral internship at the Mississippi State Hospital in Whitfield, MS in 1999 and received his Ph.D. in Clinical Psychology from the University of Tennessee in 2001. Dr. Askew provided teaching, research, and clinical supervision at the graduate level when he served as the Training Director for the Clinical Psychology doctoral program at Jackson State University and as the Interim Training Director for the Mississippi State Hospital psychology residency. Dr. Askew currently provides services in the Community Living Center (CLC) and on the Palliative Care Unit (PaCU). His clinical focus serving adults and older adults with chronic and complex medical problems and rehabilitative issues includes: cognitive / neuropsychological screening and capacity evaluations; assessment, diagnosis, and treatment of psychological disorders and severe mental illness with evidence-based approaches; and providing evidence-based psychosocial and environmental interventions for reducing behavioral and psychological symptoms associated with dementia and other neuropsychiatric and mental health conditions. Dr. Askew has research interests that include: the assessment and treatment of mood disorders in the elderly, evaluation of decisional capacity, evidence-based interventions for older adults with chronic medical illness and dementia, and quantitative psychology. Dr. Askew currently serves on the Mississippi Board of Psychology.

Ted Bennett, Ph.D.:

Dr. Bennett is a staff psychologist at the GVSMVAMC and Assistant Professor in the Department of Psychiatry and Human Behavior at UMMC. He received his Ph.D. in Psychology from the University of Mississippi in 2004 and completed his predoctoral internship at the Central Arkansas Veterans Healthcare System. He also completed a 2-year postdoctoral fellowship in Neuropsychology and Rehabilitation at the Methodist Rehabilitation Center in Jackson, Mississippi. In 2006, he joined the staff at the GVSMVAMC bringing us a wealth of clinical knowledge and experience in regards to neuropsychological and psychological services to adults with traumatic brain injury (TBI) and their families. As an educator, he has significant experience supervising trainees at different phases in their development, including psychology trainees (undergraduate and graduate) and medical students and residents. Dr. Bennett serves as the coordinator for the Neuropsychology emphasis area. His research interests are in the areas of ecological validity of neuropsychological testing, assessment of effort in neuropsychological testing, assessment of functional abilities in dementia and brain injury, and psychotherapy with Veterans suffering from impaired awareness.

Billy Ray Brown, Pharm D:

Dr. Brown is a clinical pharmacist with at the GVSMVAMC and Assistant Professor at the University of Mississippi School of Pharmacy. He has focused on HIV pharmacology since 1999 and served as an investigator in HIV therapeutics and adherence protocols. He has served as a consultant for community health programs focusing on HIV risk reduction in African American youth. Dr. Brown provides a comprehensive scope of practice that includes prescriptive authority, monitoring drug therapy, ordering laboratory tests and can provide mentoring on pharmaceutical aspects of HIV infection.

Randy S. Burke, Ph.D.:

Dr. Burke is a supervisory psychologist and the Chief of Psychology Service at the GVSMVAMC. He also has an appointment at the rank of Assistant Professor in the Department of Psychiatry and Human Behavior at UMMC. Dr. Burke received his Ph.D. in Psychology from Virginia Tech in 1999 and completed his predoctoral internship and postdoctoral fellowship at the UMMC/VAMC Consortium. Dr. Burke has worked as a staff psychologist at the GVSMVAMC since 2000. He is currently the site investigator on a multi-site, federally-funded grant, examining the effects of telephone-based tobacco cessation interve